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Causes of hemoptysis

Alexey Kryvenko, medical expert
Last reviewed: 06.07.2025

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The causes of hemoptysis (coughing up blood) can be divided into three groups.

Inflammatory diseases - bronchiectasis, bronchitis, pulmonary tuberculosis (involving the bronchi or cavernous process), lung abscess, pneumonia (especially caused by Klebsiella), acute respiratory viral infections.
Neoplasms - lung cancer (primarily bronchigenic).
Other conditions, among which it is especially important to highlight:
- pulmonary embolism;
- pulmonary infarction;
- acute left ventricular failure;
- congestive heart failure;
- mitral stenosis (leading to very severe pulmonary hypertension);
- traumatic injuries (including the presence of foreign bodies in the respiratory tract and pulmonary contusion);
- primary pulmonary hypertension;
- treatment with anticoagulant drugs.

Common Causes of Hemoptysis (Coughing Up Blood)

Bronchogenic carcinoma
Bronchiectasis (especially in the absence of sputum production)
Pulmonary tuberculosis
Pulmonary infarction
Increased intrapulmonary pressure due to debilitating cough
Abscesses and gangrene of the lungs
Acute pneumonia, often lobar
Acute bronchitis, tracheitis, laryngitis with viral infection
Heart defect (mitral stenosis)
Congestive heart failure
Foreign bodies of the bronchi
Trauma of the pharynx and airways

Rare Causes of Hemoptysis (Coughing Up Blood)

TELA
Goodpasture's syndrome
Vasculitis (Wegener's granulomatosis, microscopic polyangiitis)
Lung damage in diffuse connective tissue diseases (systemic lupus erythematosus)
Pulmonary arteriovenous fistulas
Thrombocytopenic purpura
Actinomycosis of the lungs
Hemophilia
Rondu-Osler syndrome (congenital telangiectasia)

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